From its Research & New Solutions Lab, Express Scripts launches ScreenRx to help patients follow doctors' orders. (PRNewsFoto/Express Scripts)

Express Scripts, St. Louis, Missouri. (PRNewsFoto/Express Scripts)

ST. LOUIS, April 16, 2012 /PRNewswire/ -- Express Scripts (NASDAQ: ESRX) today announced the launch of ScreenRx(SM), a breakthrough solution in the fight against the nation's costliest health condition: medication nonadherence.

ScreenRx is a proprietary adherence solution from the Express Scripts Research & News Solutions Lab. It detects future risk for nonadherence and tailors interventions for individual patients. Leveraging the power of predictive modeling, the tool identifies patients at highest risk for not following their doctors' orders. Once identified, patients receive personalized interventions to help them stay on their therapy.

In 2011, medication nonadherence cost the United States healthcare system $317.4 billion in treating medical complications that could have been avoided if patients had taken their medication. This amount is higher than the total medical cost of treating diabetes, congestive heart failure and cancer combined.

"ScreenRx enables Express Scripts to provide the most appropriate assistance to help each individual patient make healthier decisions, months before they might stop taking their medication," said Steve Miller, M.D., chief medical officer at Express Scripts. "This solution brings the country one step closer to more affordable and effective care."

ScreenRx considers more than 400 known factors about the patient, the physician, the disease and the prescribed therapy to identify who is most likely to stop taking their medication. The models are up to 98 percent accurate in predicting nonadherence one year in advance – nearly 9 times more accurate than what patients self-report.

Further, ScreenRx isolates the most likely reason why a patient is at-risk and intervenes appropriately. If a patient is likely to become nonadherent due to behavioral factors such as procrastination or forgetfulness, the patient may receive daily alerts, 90-day fills or auto-renewals. If a patient is likely to have clinical questions or concerns about the medication, the patient will receive a pharmacist consultation. If high cost is the primary concern, the patient may be contacted about payment assistance programs, lower cost medication alternatives and lower cost pharmacy options such as home delivery.

Express Scripts is completing a multi-year pilot program that applied ScreenRx technology to assist more than 600,000 members. Later this summer, Express Scripts plans to make ScreenRx available to all clients who choose to participate, focusing on the following therapy classes: high blood pressure, high cholesterol, diabetes, asthma and osteoporosis.

ScreenRx is the latest in a long series of innovations – including RationalMed® and the Therapeutic Resource Centers – centered on the problem of nonadherence.

New Insights into Nonadherence

Previewed today, the Express Scripts 2011 Drug Trend Report reveals that, for many therapy classes, less than 50 percent of patients take their medication as prescribed. As a result, the United States wastes an estimated $317.4 billion each year on unnecessary medical costs—such as emergency room visits, hospitalizations and extra tests—to treat health complications that could have been avoided.

Eliminating nonadherence would cover the cost of providing healthcare for more than 44.8 million uninsured Americans.

Americans value adherence, but patients with chronic conditions are not as adherent as they think they are. New Express Scripts research shows that more than 90 percent of respondents agree that taking medications is important for their health – more important than both eating a healthy diet and getting enough exercise. However, when nonadherent patients were asked about their own behaviors, 89 percent incorrectly reported that they were taking their medication as prescribed.

ScreenRx pilot programs reveal that 69 percent of instances of nonadherence are caused by forgetfulness and procrastination, 16 percent are because of the cost of the medication, and 15 percent stem from clinical questions or concerns the patient has about the medication or the disease.

"For an adherence solution to succeed, it needs to achieve two very different goals," Dr. Miller said. "First, it must be able to detect an asymptomatic problem across a broad population. Then, it must diagnose and address each individual patient's unique obstacle."

Other Drug Trend Report Findings

The Drug Trend Report also quantifies changes in drug trend on a year-over-year basis for all major therapy classes, using Express Scripts claims data. Drug trend comprises a range of attributes, including unit costs, utilization, dispensing practices, adherence levels and use of generics and lower-cost brands.

U.S. spending on prescription drugs increased 2.7 percent in 2011, the lowest annual drug trend Express Scripts has ever recorded in its 18 years of measuring the statistic. Trend for traditional medications fell to 0.1 percent, while specialty-drug trend continued its rapid growth with a 17.1 percent increase.

Other notable data from 2011 include a 7.0 percent trend in diabetes, which now accounts for the country's largest drug spend.

The top three specialty classes – inflammatory conditions, multiple sclerosis and cancer – represent 57.6 percent of total specialty spending. The specialty therapy class with the highest cost increase in 2011 was Hepatitis C, where the introduction of two new medications contributed to a near-doubling of drug spending to treat the disease.

The average member copayment continues its annual decline, now down to $12.02 per prescription. The average copay was $12.10 in 2010 and $13.46 in 2006.

"With national drug trend stabilized below the rate of inflation, Express Scripts is focusing our innovation and leadership on the pressing challenges that remain for the industry," said Dr. Miller. "None of these challenges is greater than nonadherence."

Express Scripts is leading the way toward creating better health and value for patients through Consumerology®, the advanced application of the behavioral sciences to healthcare. This approach is helping millions of members realize greater healthcare outcomes and lowering cost by assisting in influencing their behavior.